1. The Field of the Present Disclosure
The present disclosure relates generally to orthopaedic methods and apparatus, and more particularly, but not necessarily entirely, to methods and apparatus for use in arthroplasty treatments.
2. Description of Related Art
Arthroplasty techniques are varied, but share the same goal of removing the dysfunctional arthritic joint areas and replacing them with materials that preserve joint function. Specifically, hip arthroplasty treatments or procedures are intended to provide a pain-free weight bearing joint whose motion replicates the native hip joint.
Arthroplasty procedures of the hip joint specifically target disease of the femoral head (ball portion) and acetabulum (socket portion). Traditional total hip replacement surgery excises the femoral head and a portion of the femoral neck as well as reaming the acetabulum. Resurfacing-type procedures excise a portion of the femoral head both distally and around the edges as well as reaming the acetabulum. Partial resurfacing procedures typically result in a portion of the femoral head being resected. Substituted in their place are materials that possess durability and function.
Surgical techniques to accomplish arthroplasty goals are typically open techniques, rather than arthroscopic type techniques. Open techniques typically involve a full incision that substantially exposes the hip joint, resulting in significant iatrogenic soft tissue trauma. Arthroscopic techniques used in arthroplasty treatments are typically made from the anterior aspect of the thigh, wherein the two arthroscopic portals are the anterior/mid anterior and antero-lateral. Other portals have also been utilised, including the accessory lateral portal and postero-lateral portal.
Although arthroscopic examination, evaluation, and treatment of the hip and hip region exist, techniques used in hip arthroplasty treatments typically require substantial dislocation of the hip joint, with associated soft tissue dissection, for enabling the necessary tools/devices to be used in situ and to install any required prosthesis.
For example, U.S. Patent Publication No. 2003/0130741, published Jul. 10, 2003 to McMinn, discloses a method of resurfacing a hip joint using a first incision made at the patient's hip joint, and a second incision made at the outer side of the patient's thigh. In particular, McMinn first teaches that a guide wire is installed through the second incision up and into the femoral head and neck. Following insertion of the guide wire, McMinn next teaches that the femoral head is dislocated from the acetabulum. With the femoral head dislocated, the guide wire is then over-drilled to produce a canal up the femur and exiting the zenith of the femoral head. Using a drive rod inserted through the second incision and up the femoral canal, the periphery of the femoral head is resected using a sleeve cutter inserted through the first incision. A sleeve resection guide inserted through the first incision is then utilized to resect an appropriate amount of the zenith of the femoral head using a cutting blade. A chamfer cutter, inserted through the first incision, is then utilized to cut the femoral head to provide a chamfer thereon. Once the femoral head has been prepared, an acetabular reamer is inserted through the first incision and connected to the drive rod. The acetabular reamer can then be utilized to ream the acetabulum. McMinn then teaches the installation of an acetabular cup and femoral component are implanted.
By way of another example, U.S. Pat. No. 7,695,474, granted Apr. 13, 2010 to Crofford, discloses a method of resurfacing a hip joint using a femoral neck fixation prosthesis. Crofford discloses that an artificial femoral head is attached to a fixation prosthesis, which extends coaxially through a femoral canal formed in the femoral neck, into the femur, and is then attached to the opposite lateral wall of the femur. Crofford further teaches that the implantation of the femoral neck fixation prosthesis is accomplished by resecting the femoral head, reaming at least one passage in the femoral neck, reaming the acetabulum, and implanting the femoral neck fixation prosthesis into the reamed passage. Crofford further discloses that access to the femoral head and neck is accomplished by dislocating the femoral head from the acetabulum and rotating the leg of the patient to expose the head and neck.
One drawback of the method taught in McMinn and Crofford is the explicit requirement that the hip be dislocated during the procedure in order to expose the femoral head and neck. In particular, while hip dislocation during hip arthroplasty surgery is beneficial to expose the femoral head and neck, this procedure may cause significant soft tissue damage that may prolong patient recovery time and increase the probability of postoperative complications. Accordingly, there is a need in the art for improved methods and apparatus for arthroplasty treatments using arthroscopic techniques which lower the risk of iatrogenic injury, postoperative complications, and provide improved means for performing arthroscopic hip treatments and procedures.
The prior art is thus characterized by several disadvantages that are addressed by the present disclosure. The present disclosure minimizes, and in some aspects eliminates, the above-mentioned failures, and other problems, by utilizing the methods and structural features described herein.
The features and advantages of the present disclosure will be set forth in the description which follows, and in part will be apparent from the description, or may be learned by the practice of the present disclosure without undue experimentation. The features and advantages of the present disclosure may be realized and obtained by means of the instruments and combinations particularly pointed out in the appended claims.